Analysis Of Lymphocyte Subsets Reconstitution And Correlation Factors After Allogeneic Hematopoietic Stem Cell Transplantation

Objective: To investigate the changes of lymphocyte subsets in patients with allogeneic hematopoietic stem cell transplantation(allo-HSCT)for 1 year and to analyze the related factors effected on lymphocyte subsets.Method: Retrospective analysis was applied in 36 cases receiving allo-HSCT from March 2013 to 2016 in the 2nd Affiliated Hospital of Chongqing Medical University.The absolute counts of lymphocyte subsets were measured by flow cytometry in peripheral blood of patients before transplantation,and 1 month,3 months,6 months,12 months after transplantation.The changes of lymphocyte immunophenotyping were analyzed by the following markers including CD3+,CD4+,CD8+,CD19+,CD16+CD56+(NK cells),and CD4+CD25+Fox P3+(Treg cells).Also,analyze the effects of the patient age,HLA matching status,graft versus host disease and infection complications on lymphocyte subsets.Results: The count of CD3 + T lymphocyte was significantly decreased 1 month after transplantation,then gradually increased 3 months later,and reached the pre-transplant levels 6 months later.The count of CD4 + lymphocyte was significantly decreased 1 month later,gradually increased 3 months,and did not return to the pre-transplantation level after 12 months;The count of CD8 + lymphocyte had a less decrease 1 month after transplantation compared with the CD4+ lymphocyte,increased significantly and exceeded the pre-transplant level three months later,and significantly higher than the pre-transplant levels 12 months later;The CD4 + / CD8 + ratio was inverted after transplantation.The count of CD19 + B lymphocyte was significantly decreased 1 month after transplantation,still significantly lower than the pre-transplantation level 6 months later,and basically recovered to the pre-transplant levels 12 months later.The count of NK cell did not change significantly 1 month after transplantation,gradually increased and exceeded the pre-transplant levels after 3 months,and significantly exceeded pre-transplant levels 12 months later.The count of regulatory T cell(Treg)was decreased slightly 1 month after transplantation,and reached the pre-transplant levels 6 months later.There is no significant difference in lymphocyte subsets count between the patients 40 or more than 40 years old and those younger than 40 years old.Also there is no significant difference in the infected patients and non-infected patients;The HLA full-matched transplantation had a faster reconstitution of lymphocyte subsets compared with haploidentical transplantation.The patients with grade II-IV a GVHD had a lower count of CD3 + lymphocyte,CD4 + lymphocyte,CD19 + lymphocyte and NK cell compared with grade 0-I a GVHD.Conclusion: Our research suggests that there exists a certain regularity in recovery of the count of lymphocyte subsets in the patients receiving allo-HSCT.In all potent factors,it shows that the age of the patient and the post-transplant infection not to affect the immune reconstitution.However,a GVHD may delay the recovery of early lymphocytes.HLA full-matched transplantation other than haploidentical transplantation is more beneficial to the reconstitution of lymphocyte subsets.